... COLUMBIA S.C. Sept. 10 /- Harvard Medical Schoolre...Researchers from the medical school's Department of Health Care Policy...BlueWorks is a partnership between the Blue Cross and Blue ShieldAsso...A pre-certification from the insurer to the provider is required fors...

COLUMBIA, S.C., Sept. 10 /PRNewswire/ -- Harvard Medical School
researchers have honored BlueCross BlueShield of South Carolina for an
innovation that allows health care providers to obtain member pre-
certifications in seconds over the Internet, making the pre-certification
process more efficient and less costly.

Researchers from the medical school's Department of Health Care Policy
selected BlueCross' "Web Precert" tool as one of seven national
BlueWorks(R) winners in honor of "BlueWorks for Providers Week," Sept.
10-14.

BlueWorks is a partnership between the Blue Cross and Blue Shield
Association and Harvard's Department of Health Care Policy that recognizes
innovative Blue Cross and Blue Shield companies working with doctors and
hospitals to increase the efficiency and consistency of care delivery
nationwide. Harvard researchers judged Blue Cross and Blue Shield local
programs on innovation, efficacy, robust design and the potential for
program replication. Since 2004, Harvard Medical School's Department of
Health Care Policy has named 35 Blue Cross and Blue Shield programs as
BlueWorks winners.

A pre-certification from the insurer to the provider is required for
some medical services. With Web Precert, physicians go to the secure My
Insurance Manager(SM) section of http://www.SouthCarolinaBlues.com or
http://www.BlueChoiceSC.com and enter the member's identifying information to
determine if pre-certification is required. If pre-certification is needed,
the physician or staff member can enter clinical information online and
receive a response for the majority of requests within seconds. About 13
percent of requests are held until additional clinical information is
submitted.

Prior to implementation of Web Precert in 2005, doctors' offices
submitted these requests by telephone or facsimile.

"I would say it saves me at least 15 to 20 minutes per
pre-certification, and that is very important for me because I pre-cert for
seven doctors," said Vicki Peebles, director of marketing and
pre-certification for Blue Ridge Orthopaedics Associates in Seneca, S.C. "I
can get backed up very quickly if I have to request a pre-certification by
phone and I'm on hold for 30 minutes. I can complete a request online with
BlueCross in less than five."

David Boucher, assistant vice president of Health Care Services for
BlueCross, said Web Precert was developed because physicians requested the
ability to obtain pre-authorizations online.

"BlueCross BlueShield of South Carolina is committed to providing our
physicians, facilities and other health care providers with the information
and tools they need to interact with us in the most efficient manner
possible," Boucher said. "We believe the ability to access key
authorization information quickly and easily promotes quality service and
enables better health care for our members."

Dr. Barbara J. McNeil, head of Harvard's Department of Health Care
Policy, said Web Precert allows physicians to communicate with BlueCross
more efficiently.

"Contemporary managed care requires frequent communication between the
provider and health plan," McNeil said. "This online tool allows providers
to meet the reporting needs of the health plan with less effort, when and
where it is most convenient for the provider."

Headquartered in Columbia, S.C., BlueCross BlueShield of South Carolina
and wholly owned subsidiary BlueChoice HealthPlan of South Carolina Inc.
are independent licensees of the Blue Cross and Blue Shield Association.
BlueCross BlueShield of South Carolina and its family of companies include
more than 20 subsidiaries involved in health insurance services, U.S. DOD
health plan and Medicare contracts, and other insurance and employee
benefits services.

BlueWorks is a registered mark of the Blue Cross and Blue Shield
Association. My Insurance Manager is a service mark of BlueCross BlueShield
of South Carolina.

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